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目的比较沪、疆两地急性心肌梗死(AMI)在临床特点和冠心病危险因素方面的异同,探索冠心病AMI的地域特点。方法回顾性对比分析172例上海九院AMI住院患者(上海组)和152例新疆阿克苏地区第一人民医院AMI住院患者(阿克苏组)的临床资料和实验室指标,分析其临床特点和冠心病危险因素的聚集情况。结果阿克苏组患者AMI发病年龄比上海组患者提早近11年,分别为(58.4±10.6)岁和(69.1±10.6)岁(P=0.000);维吾尔族患者发病年龄又比当地汉族患者提早近4年,分别为(57.0±10.5)岁和(60.5±10.3)岁(P=0.041);阿克苏组患者人均危险因子数量低于上海组患者,分别为(1.6±0.9)个和(1.9±1.0)个(P=0.008);其中脂质代谢紊乱者比率前者明显高于后者(P=0.006),而高血压、吸烟和2型糖尿病的比率则明显低于后者(均为P<0.01);在两组中,中、青年患者(<60岁)吸烟比率、血清甘油三酯(TG)绝对水平以及TG/HDL C比值均明显高于同组老年患者(≥60岁,均为P<0.01);阿克苏组患者血清TG水平明显高于上海组患者,分别为(2.07±1.13)mmol/L和(1.51±0.93)mmol/L(P=0.000),前者接受急诊或择期冠状动脉介入治疗(PCI)者的比例明显低于后者(16.6%对37.8%,P=0.000),而接受经静脉溶栓治疗者的比例明显高于后者(31.7%对19.4%,P=0.020),两组患者住院期严重并发症发生率相近(67.5%对63.4%,P=0.482),住院期病死率差异不明显(8.6%对14.0%,P=0.161)。结论与上海地区的AMI患者相比,新疆阿克苏地区AMI患者发病年龄较小,人均危险因子数量偏少,以TG升高为主的脂质代谢紊乱比率较高,高血压、吸烟和2型糖尿病的比率较低,接受PCI的比率偏低,但在住院期间严重并发症发生率和病死率方面接近。
Objective To compare the similarities and differences between clinical features and risk factors of coronary heart disease in acute myocardial infarction (AMI) in Shanghai and Xinjiang and explore the geographical features of AMI in coronary heart disease. Methods The clinical data and laboratory indexes of 172 AMI inpatients (Shanghai group) and 152 AMI inpatient (Aksu group) from the First People’s Hospital of Aksu, Xinjiang were retrospectively analyzed and compared. The clinical features and risk of coronary heart disease Aggregation of factors. Results The incidence of AMI in Aksu group was (58.4 ± 10.6) years and (69.1 ± 10.6) years (P = 0.000), respectively, earlier than those in Shanghai group. The incidence of AMI in Aksu group was nearly 4 times that of local Han patients (57.0 ± 10.5) years and (60.5 ± 10.3) years (P = 0.041), respectively. The mean risk factors per capita in Aksu group were (1.6 ± 0.9) and (1.9 ± 1.0) (P = 0.008). The former was significantly higher than the latter (P = 0.006), while the rates of hypertension, smoking and type 2 diabetes were significantly lower than those of the latter (P <0.01) ; The smoking rate, the absolute level of serum triglyceride (TG) and the ratio of TG / HDL C in middle and young patients (<60 years old) in both groups were significantly higher than those in the same group (≥60 years old, P < 0.01). The serum triglyceride level in patients with Aksu was significantly higher than that in Shanghai patients (2.07 ± 1.13 mmol / L and 1.51 ± 0.93 mmol / L, P = 0.000). The former received emergency or elective coronary intervention (P <0.000). The proportion of those who received intravenous thrombolysis was significantly higher than the latter (31.7% vs. 19.4%, P = 0.020) Two groups of patients were hospitalized The incidence of serious complications was similar (67.5% vs 63.4%, P = 0.482). There was no significant difference in in-hospital mortality (8.6% vs 14.0%, P = 0.161). Conclusions Compared with patients with AMI in Shanghai, AMI patients in Aksu region of Xinjiang Province have a younger age and a lower risk of perinatal risk factors, with a higher rate of dyslipidemia, with elevated TG, hypertension, smoking and type 2 diabetes mellitus Lower rates and lower rates of PCI but close in terms of serious complications and mortality during hospitalization.